TY - JOUR
T1 - Assessing response to treatment in non-small-cell lung cancer
T2 - Role of tumor volume evaluated by computed tomography
AU - Knollmann, Friedrich D.
AU - Kumthekar, Rohan
AU - Fetzer, David
AU - Socinski, Mark A.
N1 - Funding Information:
This work was supported by a grant from the Radiological Society of North America Research and Education Foundation .
PY - 2014/3
Y1 - 2014/3
N2 - Introduction We set out to investigate whether volumetric tumor measurements allow for a prediction of treatment response, as measured by patient survival, in patients with advanced non-small-cell lung cancer (NSCLC). Materials and Methods Patients with nonresectable NSCLC (stage III or IV, n = 100) who were repeatedly evaluated for treatment response by computed tomography (CT) were included in a Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study. Tumor response was measured by comparing tumor volumes over time. Patient survival was compared with Response Evaluation Criteria in Solid Tumors (RECIST) using Kaplan-Meier survival statistics and Cox regression analysis. Results The median overall patient survival was 553 days (standard error, 146 days); for patients with stage III NSCLC, it was 822 days, and for patients with stage IV disease, 479 days. The survival differences were not statistically significant (P =.09). According to RECIST, 5 patients demonstrated complete response, 39 partial response, 44 stable disease, and 12 progressive disease. Patient survival was not significantly associated with RECIST class, the change of the sum of tumor diameters (P =.98), nor the change of the sum of volumetric tumor dimensions (P =.17). Conclusion In a group of 100 patients with advanced-stage NSCLC, neither volumetric CT measurements of changes in tumor size nor RECIST class significantly predicted patient survival. This observation suggests that size response may not be a sufficiently precise surrogate marker of success to steer treatment decisions in individual patients.
AB - Introduction We set out to investigate whether volumetric tumor measurements allow for a prediction of treatment response, as measured by patient survival, in patients with advanced non-small-cell lung cancer (NSCLC). Materials and Methods Patients with nonresectable NSCLC (stage III or IV, n = 100) who were repeatedly evaluated for treatment response by computed tomography (CT) were included in a Health Insurance Portability and Accountability Act (HIPAA)-compliant retrospective study. Tumor response was measured by comparing tumor volumes over time. Patient survival was compared with Response Evaluation Criteria in Solid Tumors (RECIST) using Kaplan-Meier survival statistics and Cox regression analysis. Results The median overall patient survival was 553 days (standard error, 146 days); for patients with stage III NSCLC, it was 822 days, and for patients with stage IV disease, 479 days. The survival differences were not statistically significant (P =.09). According to RECIST, 5 patients demonstrated complete response, 39 partial response, 44 stable disease, and 12 progressive disease. Patient survival was not significantly associated with RECIST class, the change of the sum of tumor diameters (P =.98), nor the change of the sum of volumetric tumor dimensions (P =.17). Conclusion In a group of 100 patients with advanced-stage NSCLC, neither volumetric CT measurements of changes in tumor size nor RECIST class significantly predicted patient survival. This observation suggests that size response may not be a sufficiently precise surrogate marker of success to steer treatment decisions in individual patients.
KW - CT
KW - Carcinoma
KW - Imaging
KW - Outcome
KW - Survival
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U2 - 10.1016/j.cllc.2013.11.001
DO - 10.1016/j.cllc.2013.11.001
M3 - Article
C2 - 24361250
AN - SCOPUS:84894027808
SN - 1525-7304
VL - 15
SP - 103
EP - 109
JO - Clinical lung cancer
JF - Clinical lung cancer
IS - 2
ER -